Tamar Abrams experienced significant personal challenges in 2022 and 2023, including the loss of her parents, retirement, and a move from Arlington, Virginia to Warren, Rhode Island. Facing health concerns as her weight and related medical issues increased, she recalled television commercials for Ozempic—a GLP-1 medication primarily used for diabetes but also associated with weight loss.
Abrams described the ads as “joyful,” noting that they showed people engaging in everyday activities energetically. “These people were enjoying the hell out of life,” she said. Influenced by the commercials’ message, she asked her doctor about Ozempic despite not having been diagnosed with diabetes.
Novo Nordisk, which manufactures Ozempic, invested heavily in direct-to-consumer advertising—an estimated $180 million in 2022 and $189 million in 2023 according to MediaRadar. By last year, overall industry spending on such advertising reached approximately $201 million for Novo Nordisk alone and more than $9 billion across all prescription drugs.
Novo Nordisk did not comment on these figures.
The legality of marketing prescription drugs directly to consumers has been debated for decades and is now receiving renewed attention from both policymakers and regulators. The issue is particularly relevant for older adults who tend to use more medications. Steven Woloshin of the Dartmouth Institute noted that aging brings more health conditions and greater exposure to drug advertising.
Prescription drug advertisements became common after the FDA relaxed regulations in 1997. Abby Alpert from the Wharton School explained that this regulatory change allowed ads as long as they included major risk information and sources for further details. The introduction of Medicare Part D in 2006 expanded prescription coverage and led to an increase in pharmaceutical advertising—especially in areas with higher populations aged 65 or older.
Research indicates that such ads increase patient requests for advertised drugs by name or category during medical appointments; doctors often comply with these requests.
However, many developed countries prohibit direct-to-consumer drug advertising. Only New Zealand and the United States permit it despite ongoing opposition from groups like the American Medical Association.
Critics argue these ads encourage overuse of costly new drugs even when cheaper alternatives are available after patents expire. A 2023 JAMA Network Open study found that nearly three-quarters of heavily advertised drugs offered little therapeutic advantage over existing treatments.
“Drugs without added therapeutic value need to be pushed, and that's what direct-to-consumer advertising does,” said Aaron Kesselheim, senior author of the study at Harvard University’s Program on Regulation, Therapeutics, and Law.
Supporters say consumer-focused ads inform patients about treatment options—particularly important for underdiagnosed conditions such as depression—and can increase use of generics along with brand-name products. “It provides information and education to patients,” Alpert said.
In September last year, a presidential memorandum called for reinstating pre-1997 restrictions on drug advertising—a stance also promoted by Health and Human Services Secretary Robert F. Kennedy Jr., who claimed “pharmaceutical ads hooked this country on prescription drugs.” The FDA reported issuing numerous warnings regarding deceptive or misleading advertisements. Marty Makary, FDA commissioner, criticized drug commercials publicly.
“There’s a lot of chatter,” Woloshin said regarding these efforts but expressed skepticism about substantial policy changes resulting soon.
Recently, however, the FDA notified Novo Nordisk about a misleading TV advertisement related to its oral Wegovy product; Novo Nordisk stated it was addressing regulators’ concerns.
Legislative action includes proposals from Sen. Angus King (I-Maine) seeking to ban consumer-directed drug ads during a medication’s first three years post-FDA approval—with support from other lawmakers including Sen. Bernie Sanders (I-Vermont), who advocated banning such advertising entirely. However, Supreme Court rulings protecting corporate speech may complicate legislative efforts against these advertisements.
Pharmaceutical companies also spend more promoting products directly to physicians than consumers; meanwhile online platforms remain less regulated than traditional television outlets regarding pharmaceutical promotions.
Disease awareness campaigns—advertising health conditions rather than specific products—are another form of marketing that critics claim can blur lines between education and promotion. Woloshin suggested improved educational campaigns could help consumers better evaluate information sources: “to help consumers become more savvy and skeptical.”
He cited research into simplified "drug facts boxes" designed to clearly summarize medication benefits and risks similar to food nutrition labels as one possible solution toward improving public understanding.
Ultimately individual patients must make informed decisions amid widespread promotion: After consulting her physician—and later an endocrinologist—Abrams began taking Ozempic due to elevated blood glucose levels. Three years later she had lost 90 pounds and saw improvement across several health measures but questioned whether she would have considered Ozempic without seeing those initial commercials:
“If I hadn't asked my new doctor about it," Abrams wondered," would she have suggested Ozempic? Or would I still weigh 270 pounds?"
The New Old Age is produced through a partnership with The New York Times.
